Find out ways to help preserve your fertility before you start your cancer treatment.

Cancer, and some cancer treatments, can affect your reproductive health. It could be worth considering ways of preserving your fertility before starting your treatment.

When you're told you have cancer, your ability to have children (your fertility) may be the furthest thing from your mind. Whether you already have children or haven't yet thought about becoming a parent, it is worth thinking about your fertility before starting some forms of cancer treatment.

Cancer treatments that can affect your fertility include chemotherapy, radiotherapy, and surgery on your reproductive organs, including the ovaries or testicles. Hormone therapies and other treatments may also have an impact on fertility, but less is known about the effects of these treatments.

It can be difficult to know what the effects of the cancer treatment will be until much later. Many people who are treated for cancer, especially those treated for cancer as children, remain fertile and go on to have a family of their own in later life.

Some find that their fertility is affected for a short time and then recovers when treatment has finished, but others find their fertility is affected for longer. It often depends on your individual circumstances, such as your age, the treatment you receive, where in your body the cancer is and whether you are male or female.

Women, cancer and fertility

stopping your ovaries from working and therefore causing an early menopause

damaging the lining of your womb

involving surgery to remove your womb

Speak to your doctor or nurse about options for preserving your fertility before you start cancer treatment. If they feel there is enough time before starting treatment, you could be referred to a fertility clinic. They can give you information about the options available and talk to you about the likelihood of them working.

Possibilities include:

storing frozen embryos (fertilised eggs)

freezing unfertilised eggs and storing them

freezing and storing ovarian tissue

The storage of ovarian tissue and its use in fertility treatments is still fairly new. Your cancer doctor will be able to tell you about this and other possible treatments, if you would like to know more.

Pregnancy and cancer treatment

It's not advisable to get pregnant during your cancer treatment, as some treatments could harm the baby. It is possible to get pregnant while you're having cancer treatment, even if your periods have stopped, so you'll need to consider using contraception or abstaining from having sex.

Read more about finding the most suitable method of contraception for you.

If you're taking the contraceptive pill, speak to your doctor about whether it's safe to keep taking it with the treatment you're having.

After your treatment, speak to your doctor or nurse about how long you need to wait before it will be safe to try to get pregnant. The length of time can vary, depending on factors such as the type of treatment you received.

If you are already pregnant when you are diagnosed with cancer, let your doctor know about the pregnancy straight away, so you can discuss the options before you have treatment.

If you get pregnant during your treatment, speak to your doctor as soon as possible. They can discuss the most appropriate options with you. These will depend upon many factors, including your cancer diagnosis and type of treatment.

Men, cancer and fertility

Cancer treatments can affect your fertility by:

stopping, or interfering with, the production of sperm

affecting the production of testosterone or other hormones involved with sexual function

damaging nerves and blood vessels in your pelvic area, which can make it difficult to get an erection or ejaculate

It may be possible to store some of your sperm before you start treatment. This is called sperm banking. You may have to provide several sperm samples over several days or weeks. These will then be frozen and stored to be used in the future as part of fertility treatment.

Under some circumstances, your doctor may not want to delay starting your cancer treatment. You can discuss any concerns you have with them.

Sperm banking is available on the NHS, but in some circumstances you may need to go private.

Contraception and cancer treatment

It is not advisable to get a woman pregnant when you're having your cancer treatment, because the treatment could affect the DNA and genetic material in your sperm, harming the baby. To protect against pregnancy during your treatment, you need to use contraception or abstain from having sex.

It may be appropriate to use a form of barrier contraception such as a condom to protect your partner, as some chemotherapy drugs may be found in your semen. This applies whether your partner is male or female.

After your cancer treatment – men and women

When you have finished receiving your cancer treatment, you may have questions regarding your fertility and having a family in the future.

Many people in this situation wonder about issues such as whether they are fertile or not, whether it is safe to try for a baby, whether the treatment can harm children they have in the future, and what will happen if they have a child and the cancer comes back.

It is natural to have a lot of questions. The best person to answer them is your doctor or specialist nurse. The answers will largely depend on your individual diagnosis, the type of cancer treatment you received and how it has affected your body.

Fertility testing

Some people decide to have a fertility test to find out whether or not they are fertile. Others prefer to wait or not to take the test at all.

Before having your fertility tested, you might like to consider a few points:

Think about whether you would prefer to know now or wait until later.

Consider how you might deal with the results of the test. It might be a good idea to talk to a family member, or your partner if you have one, about your feelings before and after receiving the results.

A fertility test may not always show accurately whether you are fertile or not. You may find that your first test shows you are not currently fertile, but that in a further test your fertility has returned. Your doctor can discuss the likelihood of this with you.

Your test results will not tell you whether your partner is able to have children or not.

Some cancer treatments can bring on an early menopause. If you have your fertility tested after your treatment and you're still fertile, but are advised that your menopause could come on earlier in life than it would have done without the treatment, you may want to think about trying to get pregnant earlier than you originally planned.

Getting support

Trying for a family and finding out whether or not you're fertile can be stressful. If you're finding any of these issues difficult, it may help to talk to someone. Consider discussing your feelings with your family, your partner, a friend or your cancer specialist.

Some people find that fertility treatments do not suit them or don't work. If this is the case, there are other options for having a family, such as adoption or surrogacy. Or you may consider not having children at all.

There is a lot to think about if you're considering any of these options, so talk them through with someone close to you or your doctor, or contact one of the organisations below for specific information and advice.